Article
Gastroenterology & Hepatology
Branden D. Tarlow, W. Ray Kim, Ajitha Mannalithara, Paul Y. Kwo, C. Andrew Bonham, Allison Kwong
Summary: This study found that MELD 3.0 scores beyond 40 are associated with increasing waitlist mortality without adversely affecting posttransplant outcomes. Uncapping the MELD score for waitlist candidates may lead to greater survival benefits from liver transplantation.
Article
Gastroenterology & Hepatology
Sarah Bernards, Ryutaro Hirose, Francis Y. Yao, Chengshi Jin, Jennifer L. Dodge, Chiung-Yu Huang, Neil Mehta
Summary: The UNOS policy to limit exception points for liver cancer patients on the waitlist has successfully reduced the dropout probability and equalized waitlist dropout rates between patients with and without HCC. However, it has also disadvantaged certain HCC patients.
LIVER TRANSPLANTATION
(2022)
Article
Cardiac & Cardiovascular Systems
Jay M. Brahmbhatt, Travis Hee Wai, Christopher H. Goss, Erika D. Lease, Christian A. Merlo, Siddhartha G. Kapnadak, Kathleen J. Ramos
Summary: Improved predictive models are needed for lung transplantation in the United States to accurately predict long-term post-transplant survival and fairly allocate organs. The existing models show poor accuracy in predicting 1-year and 3-year post-transplant mortality, and tend to overestimate the risk of death in patients.
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2022)
Article
Cardiac & Cardiovascular Systems
Carli J. Lehr, Jarrod E. Dalton, Paul R. Gunsalus, Douglas D. Gunzler, Maryam Valapour
Summary: A clinically intuitive indexing system was developed to simplify mortality risk assessment of lung transplant candidates, offering the opportunity to identify more nuanced and interpretable clinical phenotypes by reducing the dimensionality of waitlist mortality risk.
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2023)
Review
Immunology
Kentaro Noda, Masashi Furukawa, Ernest G. Chan, Pablo G. Sanchez
Summary: The existing donor shortage in lung transplantation has not been improved by only using brain-dead donors with standard criteria. Clinically, efforts have been made to explore the potential contribution of untapped donors and technological advancements, such as ex vivo lung perfusion techniques, to expand the donor pool and improve posttransplant outcomes.
Article
Cardiac & Cardiovascular Systems
Samantha Greissman, Michaela Anderson, Angela Dimango, Harpreet Grewal, Gabriela Magda, Hilary Robbins, Lori Shah, Joseph Costa, Bryan Stanifer, Frank D'-Ovidio, Miguel Leiva Juarez, Philippe Lemaitre, Joshua Sonett, Selim Arcasoy, Luke Benvenuto
Summary: Candidates with blood group O have lower lung transplantation rates despite being the most common blood type. The study reveals that waitlist outcomes for these candidates and those with other blood types vary based on disease severity and lung allocation score (LAS).
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2023)
Article
Surgery
M. Valapour, C. J. Lehr, M. A. Skeans, J. M. Smith, E. Miller, R. Goff, T. Mupfudze, K. Gauntt, J. J. Snyder
Summary: In 2020, there was a decrease in the number of lung transplants performed and candidates added to the waiting list, along with a decline in lung donors. This can be attributed to the impact of the global COVID-19 pandemic. However, the median time to transplant continued to decrease and posttransplant survival rates remained stable.
AMERICAN JOURNAL OF TRANSPLANTATION
(2022)
Article
Surgery
Liise K. Kayler, Jing Nie, Katia Noyes
Summary: The study found that the hardest-to-place kidneys accepted later in the match run were associated with higher rates of delayed graft function and graft failure.
AMERICAN JOURNAL OF TRANSPLANTATION
(2021)
Article
Cardiac & Cardiovascular Systems
Neel K. Ranganath, Jad Malas, Stacey Chen, Deane E. Smith, Stephanie H. Chang, Melissa B. Lesko, Luis F. Angel, Bonnie E. Lonze, Zachary N. Kon
Summary: This study aimed to investigate the impact of pretransplant hospital admission status on posttransplant mortality, and found an association between admission status and posttransplant mortality. High-volume centers were independently associated with improved survival.
ANNALS OF THORACIC SURGERY
(2021)
Article
Cardiac & Cardiovascular Systems
Oliver K. Jawitz, Vignesh Raman, David Becerra, Jacob Klapper, Matthew G. Hartwig
Summary: This study aimed to identify factors associated with survival beyond a decade after lung transplant. The results showed that approximately one-quarter of lung transplant recipients survived 10 years post-transplant. There were different factors associated with 1-year and 10-year survival, and the Lung Allocation Score did not impact long-term survival. Further research is needed to improve patient selection and management strategies to increase long-term survival.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2022)
Article
Cardiac & Cardiovascular Systems
Stephanie H. Chang, Luis Angel, Deane E. Smith, Julius Carillo, Darya Rudym, Melissa Lesko, Kimberly Sureau, Robert A. Montgomery, Nader Moazami, Zachary N. Kon
Summary: This study evaluates whether a modest change prioritizing high-LAS lung transplant candidates would lower wait list mortality. The results show that this simple prioritization change can decrease wait list mortality without significantly affecting posttransplant 1-year survival.
ANNALS OF THORACIC SURGERY
(2021)
Article
Gastroenterology & Hepatology
Douglas N. Vanderwerken, Nicholas L. Wood, Dorry L. Segev, Sommer E. Gentry
Summary: This study estimated the survival probabilities without liver transplant for candidates with different MELD scores and IA status using real data. The research found an improvement in 90-day survival rates over the past decade and demonstrated the effectiveness of MELD in prioritizing candidates. It also showed that IA candidates have higher short-term survival rates compared to MELD 40 candidates but lower than MELD 39 candidates.
Article
Cardiac & Cardiovascular Systems
Carli J. Lehr, Andrew Wey, Melissa A. Skeans, Erika D. Lease, Maryam Valapour
Summary: This study evaluated the factors impacting lung transplant allocation, including queue updates, post-transplant survival time, time-varying effects for non-proportional hazards, and different weights for waitlist and post-transplant area under the curve. The findings suggest that incorporating equally weighted models using 5-year posttransplant survival can improve transplant outcomes under the continuous distribution system.
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2022)
Article
Surgery
Bob Z. Sun, Aaron Wightman, Douglas S. Diekema
Summary: This article examines ethical considerations of mandating COVID-19 vaccination for primary caregivers of solid organ transplant candidates. It highlights the potential improvement in overall utility in organ allocation and the need for sensitivity to the changing circumstances of disease severity, transmissibility, and vaccine effectiveness.
AMERICAN JOURNAL OF TRANSPLANTATION
(2022)
Article
Cardiac & Cardiovascular Systems
Rohit Gupta, Matthew Zheng, Andrew J. Gangemi, Huaqing Zhao, Francis C. Cordova, Gerard J. Criner, Albert J. Mamary, Sameep Sehgal
Summary: In patients with sarcoidosis on the lung transplant waitlist, female gender and severe pulmonary hypertension are associated with a higher likelihood of death, while taller minimum donor height and blood type B are protective factors against death on the waitlist. Earlier referral for transplantation should be considered for patients with these characteristics.
RESPIRATORY MEDICINE
(2022)
Article
Surgery
Jarmanjeet Singh, Denise Sese, Carli J. Lehr, Bohdan Pichurko, Kenneth McCurry, Atul C. Mehta
CLINICAL TRANSPLANTATION
(2019)
Article
Critical Care Medicine
Carli J. Lehr, Melissa Skeans, Elliott Dasenbrook, Aliza Fink, Gabriela Fernandez, Albert Faro, Maryam Valapour
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2019)
Article
Critical Care Medicine
Carli J. Lehr, Eugene H. Blackstone, Kenneth R. McCurry, Lucy Thuita, Wayne M. Tsuang, Maryam Valapour
Article
Cardiac & Cardiovascular Systems
Carli J. Lehr, Melissa Skeans, Maryam Valapour
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2020)
Article
Cardiac & Cardiovascular Systems
Carli J. Lehr, Rocio Lopez, Susana Arrigain, Jesse Schold, Christine Koval, Maryam Valapour
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2020)
Article
Surgery
M. Valapour, C. J. Lehr, M. A. Skeans, J. M. Smith, K. Uccellini, R. Lehman, A. Robinson, A. K. Israni, J. J. Snyder, B. L. Kasiske
AMERICAN JOURNAL OF TRANSPLANTATION
(2020)
Article
Surgery
Carli J. Lehr, Melissa A. Skeans, Erika D. Lease, Maryam Valapour
Summary: The US lung transplant policy changed on November 24, 2017, expanding the geographic organ distribution to a 250-nautical-mile radius. This change resulted in increased travel distance and time for organ procurement, leading to higher travel costs.
AMERICAN JOURNAL OF TRANSPLANTATION
(2021)
Review
Transplantation
Carli J. Lehr, Joseph M. Pilewski
Summary: Over the past decade, the development of highly effective CFTR modulators has significantly improved symptoms for most CF patients. Recent studies have shown that ETI has efficacy for individuals with certain CF gene mutations. CFTR modulator therapy has also demonstrated improvements in lung function, nutrition, and pulmonary exacerbation frequency in patients with ALD. However, not all individuals can access therapy or respond to modulators. Lung transplant remains an important treatment option for individuals with advanced CF lung disease.
CURRENT OPINION IN ORGAN TRANSPLANTATION
(2022)
Article
Surgery
M. Valapour, C. J. Lehr, M. A. Skeans, J. M. Smith, E. Miller, R. Goff, T. Mupfudze, K. Gauntt, J. J. Snyder
Summary: In 2020, there was a decrease in the number of lung transplants performed and candidates added to the waiting list, along with a decline in lung donors. This can be attributed to the impact of the global COVID-19 pandemic. However, the median time to transplant continued to decrease and posttransplant survival rates remained stable.
AMERICAN JOURNAL OF TRANSPLANTATION
(2022)
Article
Cardiac & Cardiovascular Systems
Carli J. Lehr, Andrew Wey, Melissa A. Skeans, Erika D. Lease, Maryam Valapour
Summary: This study evaluated the factors impacting lung transplant allocation, including queue updates, post-transplant survival time, time-varying effects for non-proportional hazards, and different weights for waitlist and post-transplant area under the curve. The findings suggest that incorporating equally weighted models using 5-year posttransplant survival can improve transplant outcomes under the continuous distribution system.
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2022)
Article
Surgery
Maryam Valapour, Carli J. Lehr, Andrew Wey, Melissa A. Skeans, Jonathan Miller, Erika D. Lease
Summary: Efforts are being made to transition the lung allocation system to a continuous distribution framework using a Composite Allocation Score (CAS) that combines multiple factors. This study compared different CAS scenarios with the current allocation system and found that the new scenarios reduced waitlist deaths and improved overall equity. It also showed similar posttransplant survival rates compared to the current system.
AMERICAN JOURNAL OF TRANSPLANTATION
(2022)
Article
Critical Care Medicine
Jarrod E. Dalton, Carli J. Lehr, Paul R. Gunsalus, Lyla Mourany, Maryam Valapour
Summary: This study examined the performance of models predicting waitlist and posttransplant survival in lung transplant allocation. The results showed that different models had similar performance in predicting waitlist and posttransplant survival, and using alternative modeling strategies and contemporary cohorts did not improve the models' performance in determining access to lung transplant.
Article
Respiratory System
Carli J. Lehr, Aliza K. Fink, Melissa Skeans, Albert Faro, Gabriela Fernandez, Elliott Dasenbrook, Maryam Valapour
ANNALS OF THE AMERICAN THORACIC SOCIETY
(2020)
Article
Surgery
M. Valapour, C. J. Lehr, M. A. Skeans, J. M. Smith, K. Uccellini, R. Lehman, A. Robinson, A. K. Israni, J. J. Snyder, B. L. Kasiske
AMERICAN JOURNAL OF TRANSPLANTATION
(2019)